Clinical predictors and prognostic impact of left ventricular thrombus recurrence.

Background: There is limited contemporary data available on the subject of left ventricular thrombus (LVT) recurrence. This study aimed to evaluate the incidence, outcomes and predictors of patients with LVT recurrence after resolution.

Methods: This was a retrospective cohort study involving 346 patients with resolved LVT at baseline, derived from an echocardiography database at a tertiary medical centre, from March 2011 to January 2021.

Extracranial-intracranial bypass for symptomatic intracranial arterial occlusion: a meta-analysis of individual patient data.

Patients with symptomatic atherosclerotic internal carotid artery (ICA) or middle cerebral artery (MCA) occlusions face a high risk of recurrent ischaemic stroke despite best medical therapy. Previous trials of extracranial-intracranial (EC-IC) bypass surgery showed no benefit for stroke prevention in this population, but they may have been underpowered. This study evaluates the efficacy of EC-IC bypass surgery in reducing the risk of the composite outcome of stroke or death within 30 days or ipsilateral ischaemic stroke beyond 30 days through 2 years.

Impact of coronary revascularization on clinical outcomes of postacute myocardial infarction patients with left ventricular thrombus.

Background: The incidence of left ventricular thrombus (LVT), a significant complication postacute myocardial infarction (AMI), has seen a decline in the percutaneous coronary intervention era. Patients may not undergo coronary revascularization due to medical contraindications or patient preference.

Objectives: This study compared post-AMI LVT patients treated with or without revascularization.

Association of Leucocyte Telomere Length With Stroke, Dementia, and Late-Life Depression: The Role of Modifiable Risk Factors.

Background And Objectives: Stroke, dementia, and late-life depression (LLD) are age-related brain diseases that pose significant public health challenges and costs. Leucocyte telomere length (LTL) is a biological aging marker influenced by both genetic and lifestyle factors. The aim of our study was to determine the association between LTL and these diseases.

Atypical Presentation of an Duplication Involving the Silencer Region: Beyond Classical Autosomal-Dominant Leukodystrophy.

Objectives: The aim of this study was to characterize the clinical, genetic, and radiologic presentation of a patient with gene duplication, including the duplication of the silencer region.

Methods: A patient who presented with muscle stiffness and constipation underwent comprehensive clinical and imaging evaluations, followed by next-generation whole-genome sequencing and optical genome mapping. In the subsequent year, the proband reported additional symptoms of muscle spasms, difficulty of relaxation of the anal sphincter, and stiffness in movements.

Stroke Risk in Head and Neck Cancer: A Meta-analysis of Reconstructed Individual Patient Survival Data.

Objective: Although previous studies suggest an increased stroke risk in head and neck cancer (HNC) survivors, the risk with various treatment modalities, including radiotherapy, is less certain. This study investigates stroke incidence and risk in HNC patients, including how different treatments influence stroke risk.

Data Sources: A literature search of PubMed, Scopus, and Embase was conducted.

Impact of number of passes and futile reperfusion in basilar artery occlusion acute ischaemic stroke.

Introduction: Mechanical thrombectomy (MT) is the standard of care in anterior circulation large vessel occlusion. A vital modifiable factor is successful reperfusion. While multiple passes improve the rates of successful reperfusion, previous studies have reported progressively diminishing returns.

Impact of smoke-free legislation on stroke risk: A systematic review and meta-analysis.

Purpose: Secondhand smoke significantly increases the risk of cerebrovascular diseases, prompting recent public smoking bans. We aimed to ascertain the effects of smoke-free legislation on stroke incidence and mortality.

Methods: We systematically searched Medline, Embase, Cochrane Library, and Scopus up to August 13, 2023, for studies reporting changes in stroke incidence following partial or comprehensive smoking bans.

Ethnic Differences in the Safety and Efficacy of Tenecteplase Versus Alteplase for Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.

Background And Purpose: Tenecteplase is a thrombolytic agent with pharmacological advantages over alteplase and has been shown to be noninferior to alteplase for acute ischemic stroke in randomized trials. However, evidence pertaining to the safety and efficacy of tenecteplase in patients from different ethnic groups is lacking. The aim of this systematic review and metaanalysis was to investigate ethnicity-specific differences in the safety and efficacy of tenecteplase versus alteplase in patients with acute ischemic stroke.

Assessment of Left Atrial Fibrosis by Cardiac Magnetic Resonance Imaging in Ischemic Stroke Patients Without Atrial Fibrillation: A Systematic Review and Meta-Analysis.

Background: Left atrial (LA) fibrosis is a marker of atrial cardiomyopathy and has been reported to be associated with both atrial fibrillation and ischemic stroke. Elucidating this relationship is clinically important as LA fibrosis could serve as a surrogate biomarker of LA cardiomyopathy. The objective of this study is to investigate the association of LA fibrosis and embolic stroke of undetermined source (ESUS) using cardiac magnetic resonance imaging.

Incidence and Outcomes of Cardiocerebral Infarction: A Cohort Study of 2 National Population-Based Registries.

Background: Cardiocerebral infarction (CCI), which is concomitant with acute myocardial infarction (AMI) and acute ischemic stroke (AIS), is a rare but severe presentation. However, there are few data on CCI, and the treatment options are uncertain. We investigated the characteristics and outcomes of CCI compared with AMI or AIS alone.

Prevalence and Association of Sarcopenia with Mortality in Patients with Head and Neck Cancer: A Systematic Review and Meta-Analysis.

Background: The objective of this meta-analysis was to assess the association of sarcopenia defined on computed tomography (CT) head and neck with survival in head and neck cancer patients.

Methods: Following a PROSPERO-registered protocol, two blinded reviewers extracted data and evaluated the quality of the included studies using the Quality In Prognostic Studies (QUIPS) tool, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework.

Migraine and atrial fibrillation: a systematic review and meta-analysis.

Background: Patients with migraines, particularly those with auras, may present with stroke. Atrial fibrillation is a known risk factor for stroke. With common pathophysiological factors between migraines and atrial fibrillation, we aimed to clarify the association between migraine and atrial fibrillation in this systematic review and meta-analysis.

Stress and burnout amongst mental health professionals in Singapore during Covid-19 endemicity.

The COVID-19 pandemic has exerted a huge emotional strain on mental health professionals (MHP) in Singapore. As Singapore transited into an endemic status, it is unclear whether the psychological strain has likewise lessened. The aims of this study were to investigate the levels of stress and burnout experienced by MHP working in a tertiary psychiatric hospital in Singapore during this phase of COVID-19 endemicity (2022) in comparison to the earlier pandemic years (2020 and 2021) and to identify factors which contribute to as well as ameliorate stress and burnout.

Comparing the Impact of Stenting vs. Medical Therapy for Intracranial Arterial Stenosis : A Systematic Review and One-stage and Two-stage Meta-Analysis of Randomized Clinical Trials.

Purpose: In the treatment of intracranial arterial stenosis (ICAS), controversies remain regarding the optimal treatment strategy. Our study aims to conduct an individual patient-level data meta-analysis of existing RCTs comparing PTAS versus best medical therapy and to identify differences in outcomes such as incidence of ischemic stroke or death.

Methods: Randomised controlled trials comparing the outcomes of stenting versus best medical therapy for patients who had symptomatic ICAS of >50%.

Revolutionizing the Management of Large-Core Ischaemic Strokes: Decoding the Success of Endovascular Therapy in the Recent Stroke Trials.

Endovascular therapy (EVT) has revolutionized the management of acute ischaemic strokes with large vessel occlusion, with emerging evidence suggesting its benefit also in large infarct core volume strokes. In the last two years, four randomised controlled trials have been published on this topic-RESCUE-Japan LIMIT, ANGEL-ASPECT, SELECT2 and TENSION, with overall results showing that EVT improves functional and neurological outcomes compared to medical management alone. This review aims to summarise the recent evidence presented by these four trials and highlight some of the limitations in our current understanding of this topic.

Prognostication of Outcomes in Spontaneous Intracerebral Hemorrhage: A Propensity Score-Matched Analysis with Support Vector Machine.

Objective: The role of surgery in spontaneous intracerebral hemorrhage (SICH) remains controversial. We aimed to use explainable machine learning (ML) combined with propensity-score matching to investigate the effects of surgery and identify subgroups of patients with SICH who may benefit from surgery in an interpretable fashion.

Methods: We conducted a retrospective study of a cohort of 282 patients aged ≥21 years with SICH.